Journal
RECENT ADVANCES IN PARKINSONS DISEASE: BASIC RESEARCH
Volume 183, Issue -, Pages 209-233Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/S0079-6123(10)83011-0
Keywords
Striatonigral; Striatopallidal; Medium spiny neuron; ERK; MAPK; Transcription; Complications
Funding
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS048235] Funding Source: NIH RePORTER
- NINDS NIH HHS [R01 NS048235-03, NS48235, R01 NS048235-02, R01 NS048235, R01 NS048235-04, R01 NS048235-05, R01 NS048235-01] Funding Source: Medline
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Dopamine (DA) replacement therapy with L-DOPA remains the most effective treatment for Parkinson's disease, but causes dyskinesia (abnormal involuntary movements) in the vast majority of the patients. The basic mechanisms of L-DOPA-induced dyskinesia (LID) have become the object of intense research focusing on neurochemical and molecular adaptations in the striatum. Here we review this vast literature and highlight trends that converge into a unifying pathophysiological interpretation. We propose that the core molecular alteration of striatal neurons in LID consists in an inability to turn down supersensitive signaling responses downstream of DA D1 receptors (where supersensitivity is primarily caused by DA denervation). The sustained activation of intracellular signaling pathways induced by each dose of L-DOPA leads to abnormal cellular plasticity and high bioenergetic expenditure. The over-exploitation of signaling pathways and energy reserves during treatment impairs the ability of striatal neurons to dynamically gate cortically driven motor commands. LID thus exemplifies a disorder where 'too much' molecular plasticity leads to plasticity failure in the striatum.
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